When supporting someone with a disability, we might need to prepare their food or assist them to eat their food.
Having a mealtime management plan is critical to ensure that we understand how best to support someone with a disability at mealtimes. Through focusing on a person-centred approach, promoting active participation and safe consumption of food and drink, we can ensure every mealtime is relaxed. And, hopefully delicious, but that’s down to who’s in charge of cooking that day.
Ethical decision-making lies at the base of mealtime management, but how can we ensure we’re making informed decisions?
Read on to learn more.
What is a mealtime management plan?
When it comes to mealtimes, for those who are vulnerable with things like swallowing or chewing, it’s important that there’s a written plan. This plan helps to ensure that how meals are prepared and eaten are safe and comfortable for everyone.
It consists of:
- The assessment process (usually carried out by a Speech Pathologist, Dietician and Doctor)
- Mealtime profile
- The plan
As per our article on food safety, basic knowledge of food safety practices is required, but the mealtime management plan goes a few steps above this.
It’s not just about the type of food prepared, optimum hygiene, avoidance of hazardous food and cross-contamination, it’s also about the correct positioning of someone when they’re eating or drinking. By sitting or standing in the right position, a person reduces the risk of aspiration and choking.
Furthermore, consistencies of food may need to be adjusted to suit a client’s needs. For example, if a client is at risk of aspiration, food and drink will need to be thicker. Textures also need to be considered, as some textures might be off-putting to a client. Have you ever had an ick with eggs? Well, imagine if you continued to try to eat eggs during this ‘off-period’, you’d be pretty unhappy, right?
Being aware of how quickly someone eats too can ensure you’re encouraging safe eating and drinking. Sometimes just reminding someone to slow down, or cutting up the food a bit smaller can avert the risk of choking.
If someone has a mealtime management plan – which many people do have – it is vital that it is followed in its entirety. Never go ‘off script.’ That’s when something very dangerous can occur.
What about a mealtime profile?
As mentioned above, a mealtime profile is an aspect of the mealtime management plan.
It is a document given to anyone who provides mealtime support to a person. This could be a family member, or a support worker. It contains a snapshot of key information; addressing certain risks that could occur if the plan isn’t followed, as well as likes and dislikes.
Who is involved in mealtime management?
There are many people involved in mealtime management; from the plan’s inception, through assessments and conversations with the client, and those around said client, to the delivery and assistance of meals.
Aside from the client – who the mealtime management plan is for – stakeholders, support workers, team leaders, family, dieticians, physiotherapists, speech therapists, dentists and occupational therapists are all involved in some way.
Speech pathologists
If someone has difficulties swallowing, a speech therapist will be involved. They can assess swallowing, food textures, and drink textures as well as provide strategies to safely support someone at mealtimes.
Occupational therapists
Advising on safe positioning, occupational therapists are very important within the mealtime management plan. They can help maintain and promote independence when it comes to mealtime tasks too with techniques and/or assistive technology or equipment.
Dentists
As healthy gums and healthy teeth are important for safe eating, dentists are also required.
Pharmacists and doctors
Some medication might interfere at mealtimes, and it’s important to know what food interacts with the medication that someone is taking. Also, how best to swallow certain medications will require a doctor or pharmacist to review the person’s mealtime management plan to best advise.
If there are any difficulties with swallowing, an x-ray might be needed to fully study the swallowing capabilities of a person.
So, what exactly is in a mealtime management plan?
The mealtime management plan will contain details such as:
- Allergies
- Contact details of who prepared the plan with a date
- Risks such as dysphagia, oral hygiene and medications
- Type of food consumption i.e orally versus enteral
- Positioning
- Types of food
- Textures
- Thickness of fluids and food
- Devices which can be used to assist with mealtimes, i.e. an easy-to-grip spoon
- Cultural and religious preferences
- Behaviours during mealtime (as well as before and after)
- Type of communication i.e. sign language or verbal
- Favourite place to eat
What to be aware of with peg or tube feeding
Enteral plans will be an additional resource in the mealtime management plan and will outline the requirements for peg feeding or tube feeding. It will contain information such as:
- Feed types
- How to administer
- Whether the person needs assistance
- Any risks
Key takeaways
Every mealtime management plan is unique to an individual and is created from an in depth assessment process.
Ensuring we have enough information on someone, with professional and clinical insights, reduces the risk of any accidents, hazards or discomfort at mealtime. Mealtimes should be happy and relaxed – it’s the best part of the day!
If you want to learn more about how best to support vulnerable people, read our other guides.
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